Michele O'Mara is a licensed
clinical social worker and therapist who specializes in gender dysphoria, including homosexual and transgender issues. O'Mara
is located in Plainfield, where she works with adults and occasionally with youths.
She is certified in
Imago Therapy, specializing in couples counseling, and is nearing completion of
in clinical sexology.She is a member of the World
Professional Association for Transgender Health (WPATH), as well as the
American Association of Sexuality Educators, Counselors, and Therapists
is the typical age people identify their gender?
my practice, it's usually one of three time frames. It's either really early,
like 3-5, when [in kindergarten] the division between males and females really
starts. That's usually the earliest time frame. If it doesn't happen then, it
usually happens during puberty. If it doesn't happen then, it happens at some
point in adulthood. Sometimes even after a person gets married and has kids.
The oldest person I have worked with had the realization about gender dysphoria when he was in his 60s. There isn't a
solid time frame, but I would say it is most common for people to identify very
early or during puberty.
it normal to see transgendered teenagers?
work primarily with adults in my practice. I don't have a child or adolescent
practice, but it is very common for me to receive phone calls about young
people. And frankly, there aren't a lot of services around for young people. I
have slowly started to see more and more.
to put a teenager on hormone replacement therapy when they are already going
through hormonal changes?
the earliest a doctor will put a young person on hormone replacement therapy is
around 16. And it depends on something called a person's Tanner stage. The
Tanner stage has to do with where a person is in their sexual development.
There are two lines of treatment when it comes to medically intervening. One is
to stall or stop puberty. So people that are prepubescent or
in puberty will usually be treated with a substance that will stop the
progression of puberty. It's as safe for an 18-year-old
as it is for a 40-year;
old. An 18-year-old has gone
through puberty, and at that point you're just stopping either testosterone,
if it's a biological male, or estrogen, if it's a
biological female, and adding the opposite hormone.
do parents need to know if their child thinks they are transgender?
need to know who to contact to get that child support. Because
that's probably not going to be something that most parents are equipped to
deal with. They need to know that it is usually not a phase, something
they've made up or trying to do to get attention, which are all things that I
have heard parents suggest. And that is a very painful experience. If their
child has come to them, they've taken a huge risk, a huge leap of faith that
the parent is going to be understanding.
it be confusion or an emotional phase? Could they think they are transgender
but they're mistaken?
There was one client that did not identify with gender dysphoria
but had some gender confusion, but I've never had anyone say, "I really
think I'm a girl", or "I really think I'm a guy", but [then say]
"Oops, I was wrong, I was just having an emotional breakdown." I don't
think it's one of those things that people experience lightly.
concerns should parents have?
should be concerned about the emotional well-being of
their children. The doctors are usually really good at taking care of the
physical aspect of the transition. And parents need to be concerned about
managing their own shame and misunderstanding, and any phobias that they have
about their child's gender, and what their own friends and family will think of
them so that they won't put that on their child. I think parents really need to
educate themselves. A lot of people in our culture just don't understand what
being a transgender person means. There's a lot of shame from that, and parents
need to deal with that. Participate in therapy, doctor's appointments, that
sort of thing.
NUVO: What are some of the emotions friends
and family should expect from someone who has begun the transition?
O'MARA: Often transgender folks who are
beginning a transition experience a combination of excitement and relief, for
having honored one's truth, and moving toward realizing it.Sometimes they are impulsive in their
excitement and move more quickly than those who love them are comfortable.Depending on how a person feels about
their loved ones, there may also be fear of disappointing family, fear of being
disowned and rejected, fear of always being alone, and unloved, fear of being
viewed as a "freak," and there may be some extreme self-focus in
order to see the transition through.Many of my clients also fear for their safety, and struggle with
decisions we take for granted, like:"Which bathroom should I use?" There is a lot involved in
transitioning one's gender.I
often say it is not for the weary.Unfortunately, for many people, it is a process of trading losses.The options are, live as you have been
and remain untrue to yourself and unhappy in most cases, or risk losing
friends, family, and life as you've known it but gain your sense of self.It has been my observation that the
younger a person is, the less there is to lose, and the more success he or she
is likely to experience.
For more information on transgender resources, O'Mara suggests:
by Mildred Brown